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RESEARCH PRODUCT
Arterial stiffness, endothelial and cognitive function in subjects with type 2 diabetes in accordance with absence or presence of diabetic foot syndrome
Casuccio AlessandraDomenico Di RaimondoEliana GulottaGiovanni GuercioAntonino TuttolomondoCarlo MaidaGaspare GulottaIrene SimonettaDanilo Di BonaVittoriano Della CorteAlessandro Del CuoreAntonio PintoRosaria Pecorarosubject
Malemedicine.medical_specialtySettore MED/09 - Medicina InternaEndocrinology Diabetes and Metabolism030209 endocrinology & metabolismType 2 diabetes030204 cardiovascular system & hematologyVascular stiffness03 medical and health sciencesCognition0302 clinical medicineEndothelium functionDiabetes mellitusInternal medicineHumansMedicineEndothelial dysfunctionReactive hyperemiaPulse wave velocityAgedOriginal InvestigationFoot ulcerVascular healthbusiness.industryType 2 Diabetes MellitusMiddle Agedmedicine.diseaseDiabetic footDiabetic FootSurgeryCross-Sectional StudiesDiabetes Mellitus Type 2Pulsatile FlowArterial stiffnessCardiologyCognitive function; Endothelium function; Foot ulcer; Vascular health; Vascular stiffnessFemaleEndothelium VascularCognitive functionbusinessCardiology and Cardiovascular Medicinedescription
BACKGROUND: Endothelial dysfunction is an early marker of cardiovascular disease so endothelial and arterial stiffness indexes are good indicators of vascular health. We aimed to assess whether the presence of diabetic foot is associated with arterial stiffness and endothelial function impairment. METHODS: We studied 50 subjects with type 2 diabetes mellitus and diabetic foot syndrome (DFS) compared to 50 diabetic subjects without diabetic foot, and 53 patients without diabetes mellitus, by means of the mini mental state examination (MMSE) administered to evaluate cognitive performance. Carotid-femoral pulse wave velocity (PWV) and augmentation index (Aix) were also evaluated by Applanation tonometry (SphygmoCor version 7.1), and the RH-PAT data were digitally analyzed online by Endo-PAT2000 using reactive hyperemia index (RHI) values. RESULTS: In comparison to diabetic subjects without diabetic foot the subjects with diabetic foot had higher mean values of PWV, lower mean values of RHI, and lower mean MMSE. At multinomial logistic regression PWV and RHI were significantly associated with diabetic foot presence, whereas ROC curve analysis had good sensitivity and specificity in arterial PWV and RHI for diabetic foot presence. CONCLUSIONS: Pulse wave velocity and augmentation index, mean RHI values, and mean MMSE were effective indicators of diabetic foot. Future research could address these issues by means of longitudinal studies to evaluate cardiovascular event incidence in relation to arterial stiffness, endothelial and cognitive markers.
year | journal | country | edition | language |
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2017-01-07 | Cardiovascular Diabetology |